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Fig. 1B. —52-year-old woman with aggressive systemic mastocytosis with splenomegaly; biopsy-proven mast cell infiltration of liver; and multiple skeletal mast cell infiltration of pelvis, both femora, spine, ribs, and scapulae. One day before positron emission tomography (PET), pathologic fracture of right femoral neck was diagnosed, leading to right-sided hip replacement 5 days after PET. Histology of femoral head revealed 50% bone marrow infiltration. In this patient, aggressive systemic mastocytosis was associated with chronic myelomonocytic leukemia. Radiographs show inhomogeneous pattern with mixed small osteolytic and osteoblastic areas in pelvis, both femora (B), and spine (C), as typically seen in mast cell infiltration. Note right femoral neck fracture.